Alice D Lam1, Douglas Maus2, Sahar F Zafar2, Andrew J Cole2, Sydney S Cash2. 1. Epilepsy Division, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: Lam.Alice@mgh.harvard.edu. 2. Epilepsy Division, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Abstract
OBJECTIVE: In mesial temporal lobe (mTL) epilepsy, seizure onset can precede the appearance of a scalp EEG ictal pattern by many seconds. The ability to identify this early, occult mTL seizure activity could improve lateralization and localization of mTL seizures on scalp EEG. METHODS: Using scalp EEG spectral features and machine learning approaches on a dataset of combined scalp EEG and foramen ovale electrode recordings in patients with mTL epilepsy, we developed an algorithm, SCOPE-mTL, to detect and lateralize early, occult mTL seizure activity, prior to the appearance of a scalp EEG ictal pattern. RESULTS: Using SCOPE-mTL, 73% of seizures with occult mTL onset were identified as such, and no seizures that lacked an occult mTL onset were identified as having one. Predicted mTL seizure onset times were highly correlated with actual mTL seizure onset times (r=0.69). 50% of seizures with early mTL onset were lateralizable prior to scalp ictal onset, with 94% accuracy. CONCLUSIONS: SCOPE-mTL can identify and lateralize mTL seizures prior to scalp EEG ictal onset, with high sensitivity, specificity, and accuracy. SIGNIFICANCE: Quantitative analysis of scalp EEG can provide important information about mTL seizures, even in the absence of a visible scalp EEG ictal correlate.
OBJECTIVE: In mesial temporal lobe (mTL) epilepsy, seizure onset can precede the appearance of a scalp EEG ictal pattern by many seconds. The ability to identify this early, occult mTL seizure activity could improve lateralization and localization of mTL seizures on scalp EEG. METHODS: Using scalp EEG spectral features and machine learning approaches on a dataset of combined scalp EEG and foramen ovale electrode recordings in patients with mTL epilepsy, we developed an algorithm, SCOPE-mTL, to detect and lateralize early, occult mTL seizure activity, prior to the appearance of a scalp EEG ictal pattern. RESULTS: Using SCOPE-mTL, 73% of seizures with occult mTL onset were identified as such, and no seizures that lacked an occult mTL onset were identified as having one. Predicted mTL seizure onset times were highly correlated with actual mTL seizure onset times (r=0.69). 50% of seizures with early mTL onset were lateralizable prior to scalp ictal onset, with 94% accuracy. CONCLUSIONS: SCOPE-mTL can identify and lateralize mTL seizures prior to scalp EEG ictal onset, with high sensitivity, specificity, and accuracy. SIGNIFICANCE: Quantitative analysis of scalp EEG can provide important information about mTL seizures, even in the absence of a visible scalp EEG ictal correlate.
Authors: Sameer A Sheth; Joshua P Aronson; Mouhsin M Shafi; H Wesley Phillips; Naymee Velez-Ruiz; Brian P Walcott; Churl-Su Kwon; Matthew K Mian; Andrew R Dykstra; Andrew Cole; Emad N Eskandar Journal: Epilepsia Date: 2014-03-07 Impact factor: 5.864
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Authors: Maurice Abou Jaoude; Jin Jing; Haoqi Sun; Claire S Jacobs; Kyle R Pellerin; M Brandon Westover; Sydney S Cash; Alice D Lam Journal: Clin Neurophysiol Date: 2019-11-11 Impact factor: 3.708